Laparoscopic suturing instrument with dual-action needle graspers

ABSTRACT

A suture needle driving instrument comprises a shaft, an end effector, and a grasping actuation assembly. The end effector is located at the distal end of the shaft and includes a pair of grasping arms. Each grasping arm comprises a respective pair of jaws. Each pair of jaws is operable to cooperate to grasp and release a suture needle. The grasping actuation assembly is operable to drive one jaw of each pair in one direction while simultaneously driving the other jaw of the pair in an opposite direction, to selectively grasp or release the suture needle. The actuation assembly may include a drive shaft having separate threaded regions with opposing pitch. The end effector is further operable to pass the needle from one arm to the other arm during a suturing procedure. The instrument may be used through a trocar during minimally invasive surgery.

PRIORITY

This application claims priority to U.S. Provisional Application Ser.No. 61/413,696, filed Nov. 15, 2010, entitled “PerpendicularArchitecture Gen II,” the disclosure of which is incorporated byreference herein.

BACKGROUND

In some settings it may be desirable to perform a surgical procedure ina minimally invasive manner, such as through a trocar or other type ofaccess cannula. Examples of trocars include the various ENDOPATH® EXCEL™products by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Such trocarsmay present different inner diameters, such as those ranging fromapproximately 4.7 mm to approximately 12.9 mm, allowing a surgeon tochoose a particular trocar based on a balance of considerations such asaccess needs and incision size. In some minimally invasive surgicalprocedures, at least two trocars may be inserted through the abdominalwall of the patient. An imaging device such as an endoscope may beinserted through one of the trocars to provide visualization of thesurgical site. A surgical instrument may be inserted through another oneof the trocars to perform surgery at the site. In procedures performedwithin the abdominal cavity, the cavity may be insufflated withpressurized carbon dioxide to provide more room for visualization andmanipulation of instruments. In some settings, additional trocars may beused to provide access for additional surgical instruments. Minimallyinvasive surgery may also be performed through access portals such asthe Single Site Laparoscopy Access System by Ethicon Endo-Surgery, Inc.of Cincinnati, Ohio, which provides ports for more than one surgicalinstrument through a single incision in a patient.

It may also be desirable to use sutures during some minimally invasivesurgical procedures, such as to close an opening, to secure two layersof tissue together, to provide an anastomosis, etc. Such use of suturesmay be in addition to or in lieu of using other devices and techniquessuch as clips, staples, electrosurgical sealing, etc. Performingsuturing through trocars or other minimally invasive access ports may bemore difficult than suturing in an open surgical procedure. Forinstance, manipulating a needle and suture with conventional tissuegraspers through trocars may be relatively difficult for many surgeons.Thus, improved laparascopic surgical instruments may make suturingprocedures performed through trocars relatively easier. Examples ofsurgical instruments configured to facilitate suturing through trocarsinclude the LAPRA-TY® Suture Clip Applier, the Suture Assistant, and theENDOPATH® Needle Holder, all of which are by Ethicon Endo-Surgery, Inc.of Cincinnati, Ohio. Additional suturing instruments are disclosed inU.S. Pat. No. 7,628,796, entitled “Surgical Suturing Apparatus withAnti-Backup System,” issued Dec. 8, 2009, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,071,289, entitled“Surgical Device for Suturing Tissue,” issued Jun. 6, 2000, thedisclosure of which is incorporated by reference herein; U.S. patentapplication Ser. No. 13/156,420, entitled “Laparoscopic Suture Devicewith Asynchronous In-Line Needle Movement,” filed Jun. 9, 2011, thedisclosure of which is incorporated by reference herein; and U.S.Provisional Patent Application No. 61/355,832, entitled “LaparoscopicSuture Device,” filed Jun. 17, 2010, the disclosure of which isincorporated by reference herein.

Exemplary suturing needles are disclosed in U.S. Pat. No. 6,056,771,entitled “Radiused Tip Surgical Needles and Surgical Incision Members,”issued May 2, 2000, the disclosure of which is incorporated by referenceherein; U.S. Pub. No. 2010/0100125, entitled “Suture Needle and SutureAssembly,” published Apr. 22, 2010, the disclosure of which isincorporated by reference herein; U.S. Provisional Application Ser. No.61/413,680, filed Nov. 15, 2010, entitled “Custom Needle for SutureInstrument,” the disclosure of which is incorporated by referenceherein; and U.S. patent application Ser. No. ______ [ATTORNEY DOCKET NO.END6906USNP], entitled “Needle for Laparoscopic Suturing Instrument,”filed on even date herewith, the disclosure of which is incorporated byreference herein.

While a variety of devices and methods have been made and used forsuturing tissue, it is believed that no one prior to the inventor(s) hasmade or used the technology described herein.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a perspective view of an exemplary laparoscopic suturinginstrument;

FIG. 2 depicts a side elevational view of an exemplary laparoscopicsuturing needle for use with the suturing instrument of FIG. 1;

FIG. 3A depicts a perspective view of the end effector of the suturinginstrument of FIG. 1 with the needle of FIG. 2, in a first operationalconfiguration;

FIG. 3B depicts a perspective view of the end effector and needle ofFIG. 3A, in a second operational configuration;

FIG. 3C depicts a perspective view of the end effector and needle ofFIG. 3A, in a third operational configuration;

FIG. 4 depicts a first partial perspective view of a first needlegrasping arm of the end effector of FIG. 3A;

FIG. 5 depicts a second partial perspective view of the first needlegrasping arm of FIG. 4;

FIG. 6A depicts a partial side elevational view of the first needlegrasping arm of FIG. 4, in a first operational configuration;

FIG. 6B depicts a partial side elevational view of the first needlegrasping arm of FIG. 4, in a second operational configuration;

FIG. 7 depicts a partial exploded view of the first needle grasping armof FIG. 4;

FIG. 8 depicts a first partial perspective view of a second needlegrasping arm of the end effector of FIG. 3A;

FIG. 9 depicts a second partial perspective view of the second needlegrasping arm of FIG. 8;

FIG. 10A depicts a partial side elevational view of the second needlegrasping arm of FIG. 8, in a first operational configuration;

FIG. 10B depicts a partial side elevational view of the second needlegrasping arm of FIG. 8, in a second operational configuration;

FIG. 11 depicts a partial exploded view of the second needle graspingarm of FIG. 8;

FIG. 12A depicts an end view of the end effector and needle of FIG. 3A,during an exemplary first stage of operation;

FIG. 12B depicts an end view of the end effector and needle of FIG. 3A,during an exemplary second stage of operation;

FIG. 12C depicts an end view of the end effector and needle of FIG. 3A,during an exemplary third stage of operation;

FIG. 12D depicts an end view of the end effector and needle of FIG. 3A,during an exemplary fourth stage of operation;

FIG. 12E depicts an end view of the end effector and needle of FIG. 3A,during an exemplary fifth stage of operation;

FIG. 12F depicts an end view of the end effector and needle of FIG. 3A,during an exemplary sixth stage of operation;

FIG. 12G depicts an end view of the end effector and needle of FIG. 3A,during an exemplary seventh stage of operation;

FIG. 12H depicts an end view of the end effector and needle of FIG. 3A,during an exemplary eighth stage of operation;

FIG. 13A depicts a partial perspective view of an exemplary alternativeend effector, during an exemplary first stage of operation;

FIG. 13B depicts a partial perspective view of the end effector of FIG.13A, during an exemplary second stage of operation;

FIG. 13C depicts a partial perspective view of the end effector of FIG.13A, during an exemplary third stage of operation; and

FIG. 13D depicts a partial perspective view of the end effector of FIG.13A, during an exemplary fourth stage of operation.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

It should therefore be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

I. Overview

FIG. 1 shows an exemplary laparoscopic suturing instrument (10).Instrument (10) of this example includes a handle portion (20), a shaft(100) extending distally from handle portion (20), and an end effector(200) at the distal end of shaft (100). Handle portion (20) includes agrip (22), a rocker (24), an integral power source (26), and a motor(28) in communication with the integral power source (26). Rocker (24)is resiliently biased to a generally vertical position (e.g., generallyperpendicular to grip (22)), though rocker (24) may be rocked forwardlyor rearwardly. In addition or in the alternative, rocker (24) may berocked to the left or to the right. Rocker (24) is operable to actuatefeatures of end effector (200) as will be described in greater detailbelow. Of course, rocker (24) is merely one example of a user inputfeature, and any other suitable type of user input feature may be used.

Integral power source (26) comprises a rechargeable battery in thepresent example, though it should be understood that any other suitablepower source may be used. By way of example only, instrument (10) mayuse a power source that is external to instrument (10) (e.g., coupledwith instrument (10) via a cable, etc.). Similarly, while end effector(200) is powered by motor (28) in the present example, it should beunderstood that any other suitable source may be used, including but notlimited to a manually operable mechanism. Various other suitablecomponents, features, and configurations for handle portion (20) will beapparent to those of ordinary skill in the art in view of the teachingsherein. By way of example only, handle portion (20) may be constructedin accordance with at least some of the teachings of U.S. ProvisionalPatent Application No. 61/355,832, the disclosure of which isincorporated by reference herein; and/or in accordance with at leastsome of the teachings of U.S. patent application Ser. No. 13/156,420,the disclosure of which is incorporated by reference herein.

Shaft (100) of the present example has an outer diameter sized to permitshaft (100) to be inserted through a conventional trocar (not shown).Shaft (100) also has a length sized to permit end effector (200) to bepositioned at a surgical site within a patient while also allowinghandle portion (20) to be manipulated by a user (e.g., a surgeon) from alocation outside the patient when shaft (100) is disposed in a trocar.Of course, shaft (100) need not necessarily be dimensioned for usethrough a trocar. For instance, instrument (10) may be used and/orconfigured for use in open surgical procedures.

In some versions, shaft (100) includes one or more articulatingfeatures, allowing end effector (200) to be articulated to variousangles and positions relative to the longitudinal axis defined by shaft(100). Merely illustrative examples of such articulation are taught inU.S. Provisional Application Ser. No. 61/355,832, the disclosure ofwhich is incorporated by reference herein. Various other suitable waysin which articulation may be provided will be apparent to those ofordinary skill in the art in view of the teachings herein. In additionor in the alternative, shaft (100) may be rotatable about thelongitudinal axis, relative to handle portion (20), to selectivelyposition end effector (200) at various angular orientations about thelongitudinal axis. Of course, a user may rotate the entire instrument(10) about the longitudinal axis to selectively position end effector(200) at various angular orientations about the longitudinal axis.

End effector (200) of the present example includes a first grasping arm(210) and a second grasping arm (250). As will be described in greaterdetail below, arms (210, 250) are configured to alternatingly throw andcatch a curved suturing needle (50) along a path/plane that issubstantially perpendicular to the longitudinal axis defined by shaft(100). Alternatively, arms (210, 250) may be configured to alternatinglythrow and catch needle (50) along a path that is substantially parallelto the longitudinal axis defined by shaft (100); or along some otherpath.

In some versions, arms (210, 250) pass needle (50) back and forth fromarm (42) to arm (210) and from arm (250) to arm (210) in an oscillatingmotion (i.e., back and forth in opposite directions), such that needle(50) does not traverse a circular path as needle (50) is being passedbetween arms (210, 250). Such action of needle (50) may be referred toas a “reverse reset.” In some other versions, needle (50) may be passedbetween arms (210, 250) along a circular path in a single direction.Such action of needle (50) may be referred to as a “forward reset.” Byway of example only, arms (210, 250) may move in accordance with atleast some of the teachings of U.S. Provisional Patent Application No.61/355,832, the disclosure of which is incorporated by reference herein;and/or in accordance with at least some of the teachings of U.S. patentapplication Ser. No. 13/156,420, the disclosure of which is incorporatedby reference herein. Regardless of whether arms (210, 250) movesynchronously or asynchronously, arms (210, 250) may be configured togrip and/or compress tissue that is positioned between arms (210, 250)when arms are in approximated positions, which may facilitate passage ofneedle (50) through the tissue.

FIG. 2 shows needle (50) in greater detail. Needle (50) of this exampleincludes a sharp tip (52), a blunt end (54), and a pair of graspingregions (56, 58) configured for grasping by arms (210, 250). Inparticular, grasping regions (56, 58) comprise scallops in the presentexample, though it should be understood that grasping regions (56, 58)may have various other configurations. A suture (60) is secured to amid-region of needle (50). The configuration and relationship of suture(60) and needle (50) provides an exit of suture (60) from needle (50) atan angle that is generally tangent to or oblique relative to thecurvature of needle (50). Such an angle may provide reduced drag forcesand/or reduced tissue trauma as compared to drag forces and/or tissuetrauma that might otherwise be encountered using a needle with a suturethat exits at a generally perpendicular angle.

While the example described below includes just a single strand ofsuture extending from the needle, it should be understood that two ormore strands may extend from the needle (e.g., double leg suture, etc.).As yet another merely illustrative example, suture (60) may be securedto blunt end (54) of needle (50) instead of being secured to amid-region of needle (50). In still other versions, end (54) includes asharp tip instead of being blunt. It should also be understood thatneedle (50) may be straight instead of curved in some versions. By wayof example only, needle (50) may be constructed in accordance with atleast some of the teachings of U.S. Provisional Application Ser. No.61/413,680; U.S. patent application Ser. No. ______ [ATTORNEY DOCKET NO.END6906USNP]; U.S. Pat. No. 6,056,771; and/or U.S. Pub. No.2010/0100125. Still other suitable configurations for needle (50) willbe apparent to those of ordinary skill in the art in view of theteachings herein.

It should also be understood that needle (50) may be constructed usingvarious techniques. By way of example only, needle (50) may beconstructed using metal-injection-molding (MIM) processes. Needle (50)may also be formed from a sheet, wire, tube, extrusion, or othercomponents that are bent, stamped, coined, milled, otherwise machined,and/or otherwise formed. Other suitable ways in which needle (50) may beconstructed will be apparent to those of ordinary skill in the art inview of the teachings herein.

II. Exemplary End Effector

As noted above, end effector (200) comprises a pair of grasping arms(210, 250) that are operable to selectively grasp needle (50) during asuturing procedure. Grasping arms (210, 250) are exposed relative to anendcap (102) of shaft (100). Each grasping arm (210, 250) extends alonga respective axis that is parallel to yet offset from the center axis ofshaft (100). First grasping arm (210) maintains a fixed rotationalposition relative to shaft (100) during operation of instrument (10) inthe present example. In some other versions, first grasping arm (210) isrotatable about its own longitudinal axis, relative to shaft (100).Second grasping arm (250) of the present example is rotatable about itslongitudinal axis. Such motion can be seen in the series shown by FIGS.3A-3C.

FIG. 3A shows first grasping arm (210) grasping needle (50), with secondgrasping arm (250) rotated away from needle (50), exposing sharp tip(52) of needle (50). FIG. 3B shows second grasping arm (250) rotatedtoward needle (50) to a position enabling second grasping arm (250) tograsp needle (50) and first grasping arm (210) to release needle (50).FIG. 3C shows second grasping arm (250) rotated away from first graspingarm (210), pulling needle (50) away from second grasping arm (250).After reaching this position, second grasping arm (250) may be rotatedback to the position shown in FIG. 3B, to thereby pass needle (50) backto first grasping arm (210); then rotate back to the position shown inFIG. 3A to start the cycle over again.

In the examples described herein, needle (50) is driven along a planethat is substantially perpendicular to the longitudinal axis of shaft(100). In some other examples, needle (50) is driven along a plane thatis oblique relative to the longitudinal axis of shaft (100) orsubstantially parallel to the longitudinal axis of shaft (100). Duringsome uses of instrument (10), needle (50) may deviate from the desiredperpendicular plane. Such deviation may be due to manufacturingtolerances, deflections caused by tissue or other structures, and/or forother reasons. Such deviation may be accentuated by using a needle (50)having a relatively great length. As will be described below, endeffector (200) of the present example is configured to readilyaccommodate and correct such off-plane deviations. In other words, arms(210, 250) are operable to grasp needle (50) even in instances whereneedle (50) has deviated away from the expected perpendicular plane ofmotion; and arms (210, 250) are further operable to redirect a deviatedneedle (50) back onto the expected perpendicular plane of motion.

It should be noted that suture (60) is omitted from FIGS. 3A-3C forclarity. Various components of grasping arms (210, 250) will bedescribed in greater detail below. Various ways in which grasping arms(210, 250) may be used will also be described in greater detail below.Other suitable components of and uses for grasping arms (210, 250) willbe apparent to those of ordinary skill in the art in view of theteachings herein.

A. Exemplary First Grasping Arm

FIGS. 4-7 show first grasping arm (210) in greater detail. Firstgrasping arm (210) comprises a first jaw (220) and a second jaw (230).Jaws (220, 230) are substantially aligned with each other and areslidable longitudinally relative to each other. Jaw (220) includes apair of flanges (222, 223) that are received through correspondingopenings (232, 233) of jaw (230) during assembly of arm (210).Thereafter, flanges (222, 223) prevent jaws (220, 230) from deflectingtransversely away from each other. Jaws (220, 230) also includecomplementary needle grasping features (224, 234) that are configured toselectively grasp needle (50) as will be described in greater detailbelow. The proximal portion of jaw (220) includes a transverselyextending fin (226). Likewise, the proximal portion of jaw (230) alsoincludes a transversely extending fin (236). Fins (226, 236) areslidably disposed in corresponding distal slots (241, 242) of a sheath(240). Sheath (240) extends along the length of shaft (100) and issubstantially fixed within shaft (100). In particular, sheath (240) doesnot rotate or translate relative to shaft (100) in this example. Sheath(240) thus provides a mechanical ground in the angular direction. Itshould therefore be understood that the relationship between fins (226,236) and slots (241, 242) prevent first grasping arm (210) from rotatingrelative to shaft (100). In some other versions, however, first graspingarm (210) is rotatable relative to shaft (100) (e.g., by rotating sheath(240) within shaft (100), etc.). It should also be understood that, inthe present example, the relationship between fins (226, 236) and slots(241, 242) still permits jaws (220, 230) to translate relative to sheath(240) and shaft (100).

As best seen in FIGS. 6A-6B, jaws (220, 230) are simultaneously movablein opposite directions to selectively expand or reduce an opening formedby grasping features (224, 234) to receive needle (50). For instance, inFIG. 6A, jaw (220) has moved proximally toward shaft (100) and jaw (230)has simultaneously moved distally away from shaft (100) to enlarge theopening defined by grasping features (224, 234) to receive needle (50).In FIG. 6B, jaw (220) has moved distally away from shaft (100) and jaw(230) has simultaneously moved proximally toward shaft (100) to reducethe opening defined by grasping features (224, 234) to securely graspneedle (50). In some other versions, one jaw (220, 230) remainslongitudinally stationary while the other jaw translates longitudinallyto grasp or release needle (50) between grasping features (224, 234).However, it should be understood that in versions such as the presentexample where jaws (220, 230) both move simultaneously in oppositedirections, such motion may further promote alignment of needle (50)within grasping features (224, 234) as compared to versions where onejaw (220, 230) always stays longitudinally fixed relative to shaft(100). In other words, having both grasping features (224, 234) alwaysspaced equidistantly away from the intended path of needle (50)(regardless of whether jaws (220, 230) are open as shown in FIG. 6A orclosed as shown in FIG. 6B) may better accommodate incidentaldeflections of needle (50) away from that intended path in eitherdirection during use of instrument (10). Arm (210) may thus beparticularly suited to accommodate instances where needle (50) hasdeviated away from the expected perpendicular plane of motion asdescribed above.

FIG. 7 shows exemplary features that may be used to provide thesimultaneous opposing motion of jaws (220, 230) described above. Inparticular, FIG. 7 shows a drive shaft (244) that includes a firstthreaded section (246) and a second threaded section (248). Drive shaft(244) is coaxially positioned within sheath (240) and is rotatablewithin sheath (240). Drive shaft (244) is rotatably driven by motor (28)in handle portion (20). The threading of first threaded section (246) isoriented opposite to the threading of second threaded section (248),such that threaded sections (246, 248) have opposite pitches. Theproximal portions of jaws (220, 230) together encompass the distalportion of drive shaft (244). In particular, the proximal portion of jaw(220) includes threading (228) that meshes with first threaded section(246); while the proximal portion of jaw (230) includes threading (238)that meshes with second threaded section (248). It should therefore beunderstood that threading (228) has a pitch that is opposite to thepitch of threading (238). It should also be understood that, due to therelationships and orientations of threaded sections (246, 248) andthreading (228, 238), drive shaft (244) will cause jaws (220, 230) tosimultaneously translate away from each other (FIG. 6A) when drive shaft(244) is rotated in one direction; while drive shaft (244) will causejaws (220, 230) to simultaneously translate toward each other (FIG. 6B)when drive shaft (244) is rotated in the other direction.

It should be understood that the opposing thread configuration describedabove may require relatively low torsional force to rotate drive shaft(244) to drive jaws (220, 230) toward and away from each other. Itshould also be understood that the opposing thread configurationdescribed above may provide a relatively high holding force. Forinstance, when needle grasping features (224, 234) are driven towardeach other to secure needle (50) as shown in FIG. 6B, and needle (50) isoff-plane for whatever reason (e.g., incidentally oriented slightlyobliquely relative to the longitudinal axis of shaft (100), etc.), theneedle holding forces at grasping features (224, 234) may beself-reinforcing due to opposing forces provided through the opposingthread configuration described above, providing a mechanical advantageto urge needle (50) back into the desired planar orientation, even iftissue or some other structure is resisting such movement of needle intothe desired planar orientation. Similarly, the opposing threadconfiguration described above may provide friction that acts as ananti-backup feature, substantially resisting inadvertent separation ofgrasping features (224, 234), thereby providing a very secure hold ofneedle (50). Other suitable components that may be used to provideopposing motion of grasping features (224, 234) (e.g., a pinion withopposing racks, etc.) will be apparent to those of ordinary skill in theart in view of the teachings herein.

As noted above, drive shaft (244) may be selectively driven in eitherrotational direction by motor (28), such as in response to actuation ofrocker (24). Alternatively, any other motive source and/or user inputfeature may be used. It should also be understood that, while driveshaft (244) rotates about an axis that is parallel to the axis of shaft(100), alternative drive systems that include a rotary member mayprovide rotation of such a rotary member about an axis that is notparallel to the axis of shaft (100). For instance, a pinion based drivesystem may provide rotation of a drive pinion about an axis that isperpendicular to the axis of shaft (100). Other suitable ways in whichjaws (220, 230) may be actuated will be apparent to those of ordinaryskill in the art in view of the teachings herein.

B. Exemplary Second Grasping Arm

FIGS. 8-11 show second grasping arm (250) in greater detail. Secondgrasping arm (250) comprises a first jaw (260) and a second jaw (270).Jaws (260, 270) are substantially aligned with each other and areslidable longitudinally relative to each other. Jaw (260) includes apair of flanges (262, 263) that are received through correspondingopenings (272, 273) of jaw (270) during assembly of arm (250).Thereafter, flanges (262, 263) prevent jaws (260, 270) from deflectingtransversely away from each other. Jaws (260, 270) also includecomplementary needle grasping features (264, 274) that are configured toselectively grasp needle (50) as will be described in greater detailbelow. The proximal portion of jaw (260) includes a transverselyextending fin (266). Likewise, the proximal portion of jaw (270) alsoincludes a transversely extending fin (276). Fins (266, 276) areslidably disposed in corresponding distal slots (281, 282) of a sheath(280), which will be described in greater detail below. Each jaw (260,270) of second grasping arm (250) includes a dogleg section (252, 254).Each dogleg section (252, 254) forms a pair of right angles between aproximal portion (256) of grasping arm (250) and a distal portion (258)of grasping arm (250). The configuration of dogleg sections (252, 254)provides distal portion (258) in a parallel yet offset position relativeto proximal portion (256). Thus, when grasping arm (250) is rotatedabout a longitudinal axis extending along the length of the proximalportion (256) of grasping arm (250), the distal portion (258) ofgrasping arm (250) rotates in an orbital motion about that longitudinalaxis. Such motion will be described in greater detail below.

Sheath (280) extends along the length of shaft (100) and is partiallyfixed within shaft (100). In particular, sheath (280) does not translaterelative to shaft (100) in this example, though sheath (280) isrotatable relative to shaft (100). For instance, sheath (280) may beselectively rotated in either direction by motor (28) (e.g., in responseto actuation of rocker (24), etc.). It should therefore be understoodthat rotation of sheath (280) relative to shaft (100) will providerotation of second grasping arm (250) relative to shaft (100), due tothe relationship between fins (266, 276) and slots (281, 282). As notedabove, when second grasping arm (250) is rotated by sheath (280), thedistal portion (258) of grasping arm (250) rotates in an orbital motionabout the longitudinal axis that is defined by both sheath (280) and theproximal portion (256) of grasping arm (250). In some other versions,second grasping arm (250) is non-roatatable relative to shaft (100). Itshould also be understood that, in the present example, the relationshipbetween fins (266, 276) and slots (281, 282) permits jaws (260, 270) totranslate relative to sheath (280) and shaft (100).

As best seen in FIGS. 10A-10B, jaws (260, 270) are simultaneouslymovable in opposite directions to selectively expand or reduce anopening formed by grasping features (264, 274) to receive needle (50).For instance, in FIG. 10A, jaw (260) has moved proximally toward shaft(100) and jaw (270) has simultaneously moved distally away from shaft(100) to enlarge the opening defined by grasping features (264, 274) toreceive needle (50). In FIG. 10B, jaw (260) has moved distally away fromshaft (100) and jaw (270) has simultaneously moved proximally towardshaft (100) to reduce the opening defined by grasping features (264,274) to securely grasp needle (50). In some other versions, one jaw(260, 270) remains longitudinally stationary while the other jawtranslates longitudinally to grasp or release needle (50) betweengrasping features (264, 274). However, it should be understood that inversions such as the present example where jaws (260, 270) both movesimultaneously in opposite directions, such motion may further promotealignment of needle (50) within grasping features (264, 274) as comparedto versions where one jaw (260, 270) always stays longitudinally fixedrelative to shaft (100). In other words, having both grasping features(264, 274) always spaced equidistantly away from the intended path ofneedle (50) (regardless of whether jaws (260, 270) are open as shown inFIG. 10A or closed as shown in FIG. 10B) may better accommodateincidental deflections of needle (50) away from that intended path ineither direction during use of instrument (10). Arm (250) may thus beparticularly suited to accommodate instances where needle (50) hasdeviated away from the expected perpendicular plane of motion asdescribed above.

FIG. 11 shows exemplary features that may be used to provide thesimultaneous opposing motion of jaws (260, 270) described above. Inparticular, FIG. 11 shows a drive shaft (284) that includes a firstthreaded section (286) and a second threaded section (288). Drive shaft(284) is coaxially positioned within sheath (280) and is rotatablewithin sheath (280). Drive shaft (284) is rotatably driven by motor (28)in handle portion (20). The threading of first threaded section (286) isoriented opposite to the threading of second threaded section (288),such that threaded sections (286, 288) have opposite pitches. Theproximal portions of jaws (260, 270) together encompass the distalportion of drive shaft (284). In particular, the proximal portion of jaw(260) includes threading (268) that meshes with first threaded section(286); while the proximal portion of jaw (270) includes threading (278)that meshes with second threaded section (288). It should therefore beunderstood that threading (268) has a pitch that is opposite to thepitch of threading (278). It should also be understood that, due to therelationships and orientations of threaded sections (286, 288) andthreading (268, 278), drive shaft (284) will cause jaws (260, 270) tosimultaneously translate away from each other (FIG. 10A) when driveshaft (284) is rotated in one direction; while drive shaft (284) willcause jaws (260, 270) to simultaneously translate toward each other(FIG. 10B) when drive shaft (284) is rotated in the other direction.

In some settings, the rotational position of sheath (280) is fixedrelative to shaft (100) when drive shaft (284) is rotated relative toshaft (100). Thus, sheath (280) substantially holds the rotationalposition of jaws (260, 270) when drive shaft (284) is rotated. In someother settings, sheath (280) and drive shaft (284) are rotatedsimultaneously relative to shaft (100). In some such instances, sheath(280) and drive shaft (284) are rotated in the same direction and at thesame speed, such that drive shaft (284) and jaws (260, 270) are rotatedin the same direction and at the same speed. Thus, the longitudinalpositioning of jaws (260, 270) remains fixed during such rotation. Asanother merely illustrative variation, sheath (280) and drive shaft(284) may be rotated simultaneously relative to shaft (100), but atdifferent speeds and/or in different directions. Such a scheme providesa rotation differential between jaws (260, 270) and drive shaft (284),such that jaws (260, 270) may open or close while second grasping arm(250) is simultaneously being rotated relative to shaft (100).

It should be understood that the opposing thread configuration describedabove may require relatively low torsional force to rotate drive shaft(284) to drive jaws (260, 270) toward and away from each other. Itshould also be understood that the opposing thread configurationdescribed above may provide a relatively high holding force. Forinstance, when needle grasping features (264, 274) are driven towardeach other to secure needle (50) as shown in FIG. 10B, and needle (50)is off-plane for whatever reason (e.g., incidentally oriented slightlyobliquely relative to the longitudinal axis of shaft (100), etc.), theneedle holding forces at grasping features (264, 274) may beself-reinforcing due to opposing forces provided through the opposingthread configuration described above, providing a mechanical advantageto urge needle (50) back into the desired planar orientation, even iftissue or some other structure is resisting such movement of needle intothe desired planar orientation. Similarly, the opposing threadconfiguration described above may provide friction that acts as ananti-backup feature, substantially resisting inadvertent separation ofgrasping features (264, 274), thereby providing a very secure hold ofneedle (50). Other suitable components that may be used to provideopposing motion of grasping features (264, 274) (e.g., a pinion withopposing racks, etc.) will be apparent to those of ordinary skill in theart in view of the teachings herein.

As noted above, drive shaft (284) may be selectively driven in eitherrotational direction by motor (28), such as in response to actuation ofrocker (24). Sheath (280) may also be driven by motor (28).Alternatively, any other motive source and/or user input feature may beused. It should also be understood that, while drive shaft (284) rotatesabout an axis that is parallel to the axis of shaft (100), alternativedrive systems that include a rotary member may provide rotation of sucha rotary member about an axis that is not parallel to the axis of shaft(100). For instance, a pinion based drive system may provide rotation ofa drive pinion about an axis that is perpendicular to the axis of shaft(100). Other suitable ways in which one or more components of secondgrasping arm (250) may be actuated will be apparent to those of ordinaryskill in the art in view of the teachings herein.

III. Exemplary Method of Operation

FIGS. 12A-12H depict a merely exemplary method for using surgicalinstrument (10). In particular, FIG. 12A shows end effector (200)positioned adjacent to apposed layers (300, 302) of tissue. End effector(200) is positioned such that the longitudinal axis (130) of shaft (100)is substantially parallel to the outer edges (304, 306) of tissue layers(300, 302). In this sense, “substantially parallel” simply means thatend effector (200) is oriented in relation to tissue layers (300, 302)in a manner sufficient to enable needle (50) to be passed through tissuelayers (300, 302). It should therefore be understood that longitudinalaxis (130) need not necessarily be truly parallel with outer edges (304,306), though longitudinal axis (130) may in fact be truly parallel withouter edges (304, 306) in some instances. It should also be understoodthat instrument (10) and needle (50) may be used to secure tissuetogether in an edge-to-edge arrangement rather than securing apposedlayers (300, 302) as shown. Other suitable settings in which instrument(10) and needle (50) may be used will be apparent to those of ordinaryskill in the art in view of the teachings herein. It should also beunderstood that the curved configuration of needle (50) may provide amore intuitive operation for the surgeon than a straight needle would,such as by providing better predictability for where sharp tip (52) willcome through tissue.

As shown in FIG. 12A, first grasping arm (210) is securely holdingneedle (50), with sharp tip (52) exposed. In particular, graspingportions (224, 234) of jaws (220, 230) hold needle (50) at graspingregion (56). Needle (50) is oriented along a plane that is substantiallytransverse to longitudinal axis (130). Once end effector (200) has beenpositioned as shown in FIG. 12A, the entire instrument (10) is rotatedabout longitudinal axis (130) to drive sharp tip (52) through tissuelayers (300, 302), as shown in FIG. 12B. In the example shown, therotational direction for instrument (10) is counterclockwise viewed fromthe distal end toward the proximal end, though it should be understoodthat instrument (10) may be rotated clockwise instead (e.g., dependingon the orientation of sharp tip (52)). During the transition from theposition of FIG. 12A to the position of FIG. 12B, the rotationalposition of grasping arms (210, 250) relative to shaft (100) remainsfixed, such that grasping arms (210, 250) rotate unitarily with shaft(100) about longitudinal axis (130). The longitudinal position of jaws(220, 230, 260, 270) also remains fixed during this transition. As canalso be seen in FIG. 12B, needle (50) has started to pull suture (60)through tissue layers (300, 302) at this stage. It should be understoodthat, in the stages shown in FIGS. 12A-12B, grasping arms (210, 250) andneedle (50) are in the same rotational positions relative to shaft (100)as shown in FIG. 3A. It should also be noted that the configuration ofend effector (200) and needle (50) may provide the surgeon with enhancedvisibility of sharp tip (52) exiting tissue layers (300, 302) during thetransition from FIG. 12A to FIG. 12B, particularly with arm (250) beingrotated out of the way at this stage.

After needle (50) has been driven at least partially through tissuelayers (300, 302), second grasping arm (250) is rotated about its ownaxis (140) toward needle (50) as shown in FIG. 12C. Such rotation isprovided by rotating sheath (280) relative to shaft (100). Therotational position of shaft (100) relative to axis (130) remains fixedduring the transition from the configuration shown in FIG. 12B to theconfiguration shown in FIG. 12C. It should be understood that, in thestage shown in FIG. 12C, grasping arms (210, 250) and needle (50) are inthe same rotational positions relative to shaft (100) as shown in FIG.3B.

In some versions, jaws (260, 270) are already opened (as shown in FIG.10A) by the time second grasping arm (250) starts rotating from theposition shown in FIG. 12B to the position shown in FIG. 12C. In someother versions, jaws (260, 270) are actively opened during thetransition from the position shown in FIG. 12B to the position shown inFIG. 12C, such that jaws (260, 270) are fully open by the time secondgrasping arm (250) reaches the position shown in FIG. 12C. Once secondgrasping arm (250) reaches the position shown in FIG. 12C, jaws (260,270) close (as shown in FIG. 10B) to grasp needle (50) at graspingregion (58) with grasping features (264, 274). In addition, jaws (220,230) open (as shown in FIG. 8A) to release needle (50) from graspingfeatures (224, 234) at grasping region (56). In some versions, jaws(260, 270) close to grasp needle (50) at substantially the same time asjaws (220, 230) open to release needle (50). In some other versions,jaws (220, 230) do not open to release needle (50) until jaws (260, 270)have closed to grasp needle (50). Various suitable timing schemes andways in which such schemes may be carried out will be apparent to thoseof ordinary skill in the art in view of the teachings herein.

Once control of needle (50) has been effectively passed from graspingarm (210) to grasping arm (250), grasping arm (250) is rotated aboutaxis (140) to the position shown in FIG. 12D. Such rotation is providedby once again rotating sheath (280) relative to shaft (100). Therotational position of shaft (100) relative to axis (130) continues tobe fixed during the transition from the configuration shown in FIG. 12Cto the configuration shown in FIG. 12D. It should be understood that, inthe stage shown in FIG. 12D, grasping arms (210, 250) and needle (50)are in the same rotational positions relative to shaft (100) as shown inFIG. 3C. As can also be seen in FIG. 12D, grasping arm (250) pullssuture (60) through tissue layers (300, 302) during the transition fromFIG. 12C to FIG. 12D.

After reaching the configuration shown in FIG. 12D, the surgeon pullsthe entire end effector (200) away from tissue layers (300, 302), alonga path that is substantially transverse to axis (130), as shown in FIG.12E. It should be understood that this path may be oblique relative toaxis (130) and/or edges (304, 306), helical, and/or of any othersuitable configuration. It should also be understood that neither arm(210, 250) is rotated relative to shaft (100) in the present exampleduring the transition from the position shown in FIG. 12D to theposition shown in FIG. 12E. Thus, in the stage shown in FIG. 12E,grasping arms (210, 250) and needle (50) are still in the samerotational positions relative to shaft (100) as shown in FIG. 3C. Inmoving instrument (10) away from tissue layers (300, 302) during thetransition to the position shown in FIG. 12E, suture (60) is pulledfurther through tissue layers (300, 302).

With end effector (200) positioned sufficiently away from tissue layers(300, 302), second grasping arm (250) is rotated about axis (140) to theposition shown in FIG. 12F. The rotational position of shaft (100)relative to axis (130) remains fixed during the transition from theconfiguration shown in FIG. 12E to the configuration shown in FIG. 12F.It should be understood that, in the stage shown in FIG. 12F, graspingarms (210, 250) and needle (50) are in the same rotational positionsrelative to shaft (100) as shown in FIG. 3B. End effector (200) ispositioned far enough away from tissue layers (300, 302) during thetransition from the position shown in FIG. 12E to the position shown inFIG. 12F such that blunt end (54) of needle (50) does not touch tissuelayers (300, 302). The rotation of second grasping arm (250) to theposition shown in FIG. 12F places grasping region (58) of needle (50)back between grasping portions (224, 234) of jaws (220, 230).

In some versions, jaws (220, 230) are already opened (as shown in FIG.8A) by the time second grasping arm (250) starts rotating from theposition shown in FIG. 12E to the position shown in FIG. 12F. In someother versions, jaws (220, 230) are actively opened during thetransition from the position shown in FIG. 12E to the position shown inFIG. 12F, such that jaws (220, 230) are fully open by the time secondgrasping arm (250) reaches the position shown in FIG. 12F. Once secondgrasping arm (250) reaches the position shown in FIG. 12F, jaws (220,230) close (as shown in FIG. 8B) to grasp needle (50) at grasping region(56) with grasping portions (224, 234). In addition, jaws (260, 270)open (as shown in FIG. 10A) to release needle (50) from graspingportions (264, 274) at grasping region (58). In some versions, jaws(220, 230) close to grasp needle (50) at substantially the same time asjaws (260, 270) open to release needle (50). In some other versions,jaws (260, 270) do not open to release needle (50) until jaws (220, 240)have closed to grasp needle (50). Various suitable timing schemes andways in which such schemes may be carried out will be apparent to thoseof ordinary skill in the art in view of the teachings herein.

Once control of needle (50) has been effectively passed from graspingarm (250) back to grasping arm (210), grasping arm (250) is rotatedabout axis (140) to the position shown in FIG. 12G. Such rotation isprovided by once again rotating sheath (280) relative to shaft (100).The rotational position of shaft (100) relative to axis (130) continuesto be fixed during the transition from the position shown in FIG. 12F tothe position shown in FIG. 12G. It should be understood that, in thestage shown in FIG. 12G, grasping arms (210, 250) and needle (50) are inthe same rotational positions relative to shaft (100) as shown in FIG.3A.

Once grasping arm (250) has been rotated away from needle (50) as shownin FIG. 12G, the entire instrument (10) is once again rotated aboutlongitudinal axis (130) to position sharp tip (52) above tissue layers(300, 302), as shown in FIG. 12H. In the example shown, the rotationaldirection for instrument (10) is again counterclockwise viewed from thedistal end toward the proximal end, though it should be understood thatinstrument (10) may be rotated clockwise instead (e.g., depending on theorientation of sharp tip (52)). During this transition, the rotationalposition of grasping arms (210, 250) relative to shaft (100) remainsfixed, such that grasping arms (210, 250) rotate unitarily with shaft(100) about longitudinal axis (130). The longitudinal position of jaws(220, 230, 260, 270) also remains fixed during this transition. In thestage shown in FIG. 12H, grasping arms (210, 250) and needle (50) remainin the same rotational positions relative to shaft (100) as shown inFIG. 3A.

Having reached the configuration shown in FIG. 12H, end effector (200)may be moved back toward tissue layers (300, 302), such as along a pathtransverse to axis (130), to again reach the position shown in FIG. 12A.The above described cycle may then be repeated as many times as desireduntil an appropriate number of stitches have been made through tissuelayers (300, 302). The free end of suture (50) may then be knotted,clipped, or otherwise secured.

It should be understood that instrument (10) may be advanced distally orproximally along axis (130) in each stitching cycle, each stitchingcycle being represented by the succession of stages depicted in FIGS.12A-12H. For instance, instrument (10) may be advanced distally orproximally along axis (130) during the transition from the positionshown in 12E to the position shown in 12F. As another merelyillustrative example, instrument (10) may be advanced distally orproximally along axis (130) during the transition from the positionshown in 12G to the position shown in 12H. Other suitable stages atwhich instrument (10) may be advanced distally or proximally will beapparent to those of ordinary skill in the art in view of the teachingsherein. It should be understood that the distance of each incrementaldistal or proximal movement of instrument (10) during successivestitching cycles may be selected based on a desired stitch density alongthe length of the tissue being sutured. It should also be understoodthat, once stitching is complete, suture (60) may define a generallyhelical path through tissue layers (300, 302). Other suitable ways inwhich instrument (10) may be used will be apparent to those of ordinaryskill in the art in view of the teachings herein.

As should be apparent to those of ordinary skill in the art, needle (50)of the present example orbits about axis (140), which is offset fromaxis (130) of shaft (100) in the present example. This may enable needle(50) to travel about an arc having a radius that is greater than theradius of a trocar through which shaft (100) is inserted. In otherwords, the circumferential path of needle (50) need not be limited tothe circumference of the trocar through which shaft (100) is insertedwhen the orbital axis of needle (50) is offset from axis (130) of shaft(100). Thus, the configuration of end effector (200) in the presentexample may permit a larger radius needle to be used, and largerstitches to be made, than what would be permitted if the orbital motionof needle (50) were centered about axis (130) of shaft (100). In someother versions, needle (50) does move in an orbital fashion about axis(130) of shaft (100).

IV. Exemplary Alternative End Effector

FIGS. 13A-13D depict an exemplary alternative end effector (400)disposed at the distal end of a shaft (500). End effector (400) of thisexample comprises a first arm (410) and a second arm (450). Either orboth arms (410, 450) may be driven by a motor, manual mechanism, and/orsome other feature. First arm (410) includes a needle grasping feature(412) and a dogleg section (414). Second arm (450) includes a needlegrasping feature (462) and a dogleg section (464). Needle graspingfeatures (412, 462) are each operable to selectively grasp and release aneedle (600). Various suitable components and configurations for needlegrasping features (412, 462) will be apparent to those of ordinary skillin the art in view of the teachings herein. Dogleg sections (414, 464)are configured such that the distal portions of arms (410, 450) arespaced apart to a distance exceeding the outer diameter of shaft (500).Each arm (410, 450) is independently rotatable about its own respectiveaxis, relative to shaft (500). In some other versions, only one arm(410, 450) is rotatable relative to shaft (500) while the rotationalposition of the other arm (450) remains fixed relative to shaft (500).

Needle (600) of this example includes a first sharp tip (602) and asecond sharp tip (604). A suture (610) is secured to a mid-region ofneedle (600). Needle (600) may be constructed in accordance with variousteachings above and/or in accordance with at least some of the teachingsof one or more of the references that are cited herein. Various suitableconfigurations for needle (600) will be apparent to those of ordinaryskill in the art.

In a merely exemplary use of end effector (400) and needle (600), endeffector (400) and needle (600) are positioned with sharp tip (604)adjacent to tissue (700) as shown in FIG. 13A. Then, the entire assemblyof shaft (400) and end effector (400) is rotated approximately 90°counterclockwise to the position shown in FIG. 13B. The positions ofarms (410, 450) remain substantially fixed relative to shaft (500)during this transition. As can be seen in FIG. 13B, sharp tip (604) isdriven through tissue (700) during the transition from FIG. 13A to FIG.13B. Next, arm (410) is rotated clockwise toward sharp tip (604) to theposition shown in FIG. 13C. The rotational position of shaft (500) andarm (450) remain substantially fixed during this transition. With arm(410) at the position shown in FIG. 13C, grasping feature (412) graspsneedle (600) and grasping feature (452) releases needle (600). Asdescribed above, this grasping and releasing may occur in stages and/orsimultaneously.

Once control of needle (600) has been effectively passed from arm (450)to arm (410), arm (410) is rotated counterclockwise to the positionshown in FIG. 13D. The rotational position of shaft (500) and arm (450)remain substantially fixed during this transition. The movement of arm(410) from the position shown in FIG. 13C to the position shown in FIG.13D pulls needle (600) and suture (610) through tissue (700). At thisstage, arm (410) may continue to rotate counterclockwise relative toshaft (500) until tip (602) clears tissue (700). Alternatively, shaft(500) and the entire end effector (400) may be rotated counterclockwiseuntil tip (602) clears tissue (700). Next, there are at least twooptions for further operation. One option is to pull shaft (500) and endeffector (400) transversely away from tissue (700); then pass needle(600) back to arm (450) while needle (600) is away from tissue (700), torepeat the process beginning back at the type of stage shown in FIG.13A. Another option is to simply advance shaft (500) and end effector(400) distally or proximally; then to rotate either arm (410) or theentire assembly of shaft (500) and end effector (400) to drive tip (602)back through tissue (700). After tip (602) is driven back through tissue(700), arm (450) may take control of needle (600) from arm (410), andthe process may be repeated beginning back at the type of stage shown inFIG. 13A. Still other suitable ways in which end effector (400) andneedle (600) may be used will be apparent to those of ordinary skill inthe art in view of the teachings herein.

In some variations, needle (600) includes graduations facilitatingselective gripping of needle (600) at different locations along thelength of needle (600), allowing more or less of each end of needle(600) to be exposed relative to each arm (410, 450). In addition or inthe alternative, a taper at each end of needle (600) may prevent needle(600) from being passed too far through each needle grasping feature(412, 462).

While terms such as “clockwise” and “counterclockwise” have been used todescribe directions of rotational movement during exemplary uses of endeffectors (200, 400), it should be understood that these specificrotational directions are being provided only in reference to theexamples depicted in the drawings. It is contemplated that rotationalmovement may be provided in directions opposite to those used above.Therefore, use of the terms “clockwise” and “counterclockwise” in theabove examples should not be viewed as limiting in any way.

V. Miscellaneous

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by a userimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various versions in the present disclosure,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, versions, geometries, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

1. An apparatus, comprising: (a) a shaft, wherein the shaft has a distalend; (b) an end effector located at the distal end of the shaft, whereinthe end effector comprises: (i) a first needle grasping member, and (ii)a second needle grasping member, wherein the first and second needlegrasping members are operable to cooperatingly grasp and release asuture needle; and (c) a grasping actuation assembly, wherein thegrasping actuation assembly is operable to simultaneously drive thefirst needle grasping member distally relative to the shaft and thesecond needle grasping member proximally relative to the shaft to graspa suture needle.
 2. The apparatus of claim 1, wherein the graspingactuation assembly is further operable to simultaneously drive the firstneedle grasping member proximally relative to the shaft and the secondneedle grasping member distally relative to the shaft to release asuture needle.
 3. The apparatus of claim 1, wherein the shaft and theend effector are dimensioned to fit through a surgical trocar.
 4. Theapparatus of claim 1, further comprising a handle assembly positioned ata proximal end of the shaft, wherein the handle assembly is operable toselectively activate the grasping actuation assembly.
 5. The apparatusof claim 4, wherein the handle assembly further includes at least onemotor in communication with the grasping actuation assembly.
 6. Theapparatus of claim 1, wherein the first needle grasping member isslidably coupled with the second needle grasping member.
 7. Theapparatus of claim 1, wherein the first needle grasping member comprisesa linearly movable first jaw having a first linear drive feature coupledwith the grasping actuation assembly, wherein the second needle graspingmember comprises a linearly movable second jaw having a second lineardrive feature coupled with the grasping actuation assembly, wherein thefirst and second jaw are linearly movable along a common axis.
 8. Theapparatus of claim 7, wherein the grasping actuation assembly comprisesa drive shaft having a first threaded section and a second threadedsection, wherein the first threaded section has threading oriented in afirst direction, wherein the second threaded section has threadingoriented in a second direction, wherein the second direction is oppositefrom the first direction such that first and second threaded sectionshave opposing pitch.
 9. The apparatus of claim 8, wherein the firstlinear drive feature comprises a threading meshing with the threading ofthe first threaded section of the drive shaft, wherein the second lineardrive feature comprises a threading meshing with the threading of thesecond threaded section of the drive shaft.
 10. The apparatus of claim1, wherein the end effector comprises a first arm and a second arm,wherein the first and second needle grasping members together define atleast part of the first arm.
 11. The apparatus of claim 10, wherein theshaft defines a longitudinal axis, wherein the first arm extends along afirst arm axis, wherein the first arm axis is offset from thelongitudinal axis of the shaft.
 12. The apparatus of claim 11, whereinthe first arm is rotatable relative to the shaft about the first armaxis.
 13. The apparatus of claim 11, wherein the first arm furtherincludes a dogleg feature, wherein the dogleg feature is positionedbetween a distal portion of the first arm and a proximal portion of thefirst arm, wherein the proximal portion of the first arm extends alongthe first arm axis, wherein the distal portion of the first arm extendsalong an axis that is parallel to yet offset from the first arm axis.14. The apparatus of claim 10, wherein the second arm comprises a thirdneedle grasping member and a fourth needle grasping member, wherein thethird needle grasping member and the fourth needle grasping member areoperable to cooperatingly grasp and release a suture needle.
 15. Theapparatus of claim 14, wherein the grasping actuation assembly isfurther operable to simultaneously drive the third needle graspingmember distally relative to the shaft and the fourth needle graspingmember proximally relative to the shaft to grasp a suture needle. 16.The apparatus of claim 14, wherein the end effector is operable toselectively pass a suture needle between the first arm and the secondarm.
 17. An apparatus, comprising: (a) a shaft, wherein the shaft has adistal end; (b) an end effector located at the distal end of the shaft,wherein the end effector comprises: (i) a first needle grasping jaw, and(ii) a second needle grasping jaw, wherein the first and second needlegrasping jaws are operable to cooperatingly grasp and release a sutureneedle; and (c) a rotary member operable to simultaneously drive thefirst needle grasping jaw distally relative to the shaft and the secondneedle grasping jaw proximally relative to the shaft to grasp a sutureneedle, wherein the rotary member is operable to convert rotary motionin a single direction into simultaneous linear motion of the graspingjaws in opposing directions.
 18. The apparatus of claim 17, wherein theshaft defines a longitudinal axis, wherein the end effector is furtheroperable to drive a suture needle along a plane that is perpendicular tothe longitudinal axis of the shaft.
 19. A method of operating aninstrument to drive a suture needle through tissue, wherein theinstrument comprises a first needle grasping arm and a second needlegrasping arm, wherein the first needle grasping arm comprises a firstjaw and a second jaw, wherein the first and second jaws are configuredto cooperate to grasp and release a suture needle, the methodcomprising: (a) driving the first jaw distally while simultaneouslydriving the second jaw proximally, to grasp the needle with the firstarm; (b) rotating the first arm about an axis to drive the needlethrough tissue; (c) grasping the needle with the second arm; and (d)releasing the needle from the first arm, wherein the act of releasingthe needle from the first arm comprises driving the first jaw proximallywhile simultaneously driving the second jaw distally.
 20. The method ofclaim 19, wherein the second arm comprises a third jaw and a fourth jaw,wherein the third and fourth jaws are configured to cooperate to graspand release a suture needle, wherein the act of grasping the needle withthe second arm comprises driving the third jaw distally whilesimultaneously driving the fourth jaw proximally.